More Deadly than Driving a Car

I recently had an interesting conversation with my hair stylist. She had just enrolled in college to become a licensed addiction counsellor. I asked her what why she chose that career. She said she was a former drug addict and was homeless for a short period of time and understood  lifestyle of those addicted to drugs. She has been clean for 2 plus years. During that time she received her license to cut hair and landed a job at the hair salon I frequent.

She was a wealth of information. After telling her I had ordered and recently received in the mail naloxone (Narcan) from the state (I live in Washington state, where you can order online here- it is free) and that I had been writing about the fentanyl crisis she piped up and informed me that more people died of fentanyl overdoses than motor vehicle crashes in 2021.

Intrigued, I looked up the statistics. She was correct. But the one glaring statistic was how many more perished from fentanyl overdoses compared to motor vehicle crashes.

According to USA Facts: “In 2021, 70,601 people died from a fentanyl overdose in the US. That figure is up 25% from 2020 and is nearly double the amount of fentanyl overdose deaths in 2019.”

And the USDOT reports  “NHTSA projects that an estimated 42,915 people died in motor vehicle traffic crashes last year, a 10.5% increase from the 38,824 fatalities in 2020.”

If my math is correct, 60 percent more people died from fentanyl overdose than in car crashes.

Fentanyl, a synthetic opioid analgesic was originally developed for pain management for cancer patients. It is 50-100 times stronger than morphine.

In recent times it has become a deadly street drug manufactured in the States and Mexico.

Not just illegal drug users are at risk for fentanyl overdose. The recent episode of a 10 month old baby who turned blue and limp from accidental fentanyl exposure after playing in the grass at a local park drives home the point of how widespread this epidemic has become. EMS was called and naloxone was administered. The child survived.

The toddlers’ parents warn parents to closely watch their children playing at any public park or playground. Foil packets and even spilled fentanyl in the form of powder on the grass may have been the way the toddler was exposed.

My naloxone/Narcan order arrived

I received my naloxone in the mail last week. The directions to administer were clear.

In the state I reside I had the choice of either injectable or nasal spray doses. I chose injectable because I felt there are many more sites to choose from to administer than just nasal passages (nasal spray).

As of August 2020, all 50 states and the District of Columbia have some form of a naloxone access law. The laws vary significantly by state.

To obtain naloxone, state by state resources website and information can be found here.

A few facts about Naloxone/Narcan:

Healthline has an excellent explanation and more detailed instructions on naloxone.

  • Naloxone is safe, if you administer and the patient isn’t experiencing a drug overdose there are no side effects.
  • Naloxone, blocks the effects of opioids in your body. This drug works to reverse the life-threatening symptoms that happen during an overdose. More than one dose may be necessary because there may be more opioid in the body than the naloxone can block.
  • Naloxone is only active in the body for 20 to 90 minutes, the effects of most opioids last longer. This means that the effects of naloxone are likely to wear off before the opioids are gone from the body.
  • Narcan comes in one dose, for any age- from toddler to adult
  • It’s important to note that Narcan is not a substitute for medical treatment. After giving Narcan to someone, call 911 right away, even if the person wakes up after getting Narcan.

- Brooke Lounsbury, RN

Medical Content Writer

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Sauerkraut Basics

Making sauerkraut or any fermented vegetable can be fun, nutritious, and rewarding.

A few pointers will help you achieve success

  • Use filtered or bottled water- Tap water contains antibacterial agents to inhibit harmful growth of bacteria. The same antibacterial agents kill only harmful but also beneficial bacteria.

Well water needs to be filtered also. It can contain naturally occurring minerals or even bacteria that can spoil the ferment.

  • Salt- make sure your salt doesn’t contain anti caking agents(read label- here is a list of anti caking agents on this website). Most of the time you are able to just read the salt ingredients and figure it out. There should be nothing but salt listed as an ingredient. Non iodized salt is best- Himalayan, kosher or table salt are the best options for your salt. Salt helps curb the bacterial overgrowth and regulates fermentation process. For sauerkraut a 2% salt brine is needed. Other vegetables call for varying percentages. Handy brine calculator can be found here: The probiotic jar. Or, you can add 3 tablespoons salt to every 5 lbs cabbage. Personally, I have never weighed salt, just added salt to the cabbage
  • The higher the vegetable quality the more success you will have– When shopping for vegetables to ferment, try to pick organic, or spray free vegetables. If able, locally sourced cabbage is best. If you are not able to find organic or spray free cabbage the next best thing is to remove and discard first few outer leaves. This will remove a good portion of chemical contamination that can prevent successful fermentation.
  • Clean all items that come in contact with cabbage- this includes your fermentation vessel along with knives, cutting boards and hands. Thoroughly wash knives and all items that will come in contact with the cabbage. This practice helps prevent introducing bacterial contamination into your sauerkraut which can ruin all your hard work.
  • Adequate storage area while it ferments and heat- Sauerkraut ferments best in room temperature (62-75 degrees) and no direct sunlight area of the home. A kitchen cupboard or on a counter out of direct sunlight is some areas that work well.
  • Patience- Sauerkraut goes through 3 stages of the fermentation process to achieve the probiotic and enzyme rich delicious tasting product. This process takes at least 3 weeks, If the room temperature is cooler this can take longer. The longer the cabbage is allowed to ferment the more healthy probiotic bacteria are in the product.

The stages of fermentation (these days are approximate)

Sauerkraut can be store for years if stored in a cool, dark environment

Stage 1 Days 1-5, the start of lactic acid fermentation.

Salt tolerant bacteria produce carbon dioxide. This transforms the fermentation vessel into an anaerobic environment. They break down available sugars to produce lactic acid, acetic acid (vinegar), ethyl alcohol, and mannitol, along with carbon dioxide, which are the bubbles you see floating to the surface along with brine being pushed out of the jar. The carbon dioxide to helps create an anaerobic fermentation environment by displacing any trapped oxygen.

Stage 2 Days 5-16 This phase starts once the bubbles have subsided

Lactic acid production takes place. Lactic acid acts as a preservative, supports digestion, inhibits the growth of harmful bacteria, increases the bio-availability of Vitamin C, produces enzymes, and much more

Stage 3 Days 16- 21 Ph drops and health promoting bacteria continue to flourish

The sauerkraut continues to age, and the ph drops to between 3.1 and 3.7. This acidic environment helps preserve the sauerkraut and allows the growth of the health promoting lactic acid bacteria.

Lets get started

Assemble supplies

You will need:

  • Cabbage
  • Water
  • Cutting board
  • Sharp knife
  • Salt
  • Scale to weigh salt (if you prefer to go that route)
  • Kraut pounder (or clean fist to pound cabbage into the vessel)
  • Fermentation vessel- this can be as simple as a clean mason jar or as elaborate as a fermentation crock- I tend to use my canning jars-they are inexpensive so I can make several ferments without breaking the bank.
  • Fermentation is an anaerobic (without air) process. In order to avoid spoilage, the cabbage must be completely submerged under liquid. Some people use glass fermentation stones. Others use bubble airlock sets, which is my personal preference. The glass stones tend to shift and allow air to the cabbage. The airlocks create an anaerobic environment if they are used properly. Another method is to used cabbage leaves on top of the packed cabbage, press firmly. Make sure cabbage is submerged, add stones or other weights.(a plastic bag tied off with water can be used as weight also- I have used the is method on occasion)

To make sauerkraut

The very best way to get started is to watch this video on “The complete beginners guide to fermenting foods at home”

  1. Thinly slice cabbage. You can add some carrot or a bit of garlic or hot pepper for flavor and color. I personally use the 3 tablespoons to 5 lbs cabbage method. A more precise way to ferment is to make the 2% brine solution. Link above to calculate.

2. Add salt, massage cabbage, let set in bowl for 20 minutes to 1 hour. Liquid will form in bottom of vessel.

3. Tightly pack cabbage into fermentation vessel, add the liquid that formed from massaging the cabbage. If needed add 2 percent salt brine to thoroughly cover the cabbage. Press down the cabbage, making sure there ae no air pockets trapped in the jar.

4. Add airlock or stones. Make sure that the cabbage is thoroughly submerged Place vessel in a shallow bowl or on a plate to catch any overflow from fermentation bubbles for the first week or so.

5. Set in a room temperature environment, away from direct sunlight.

6. Check daily to make sure the cabbage is submerged under the liquid. If needed, add brine to keep submerged.

7. The sauerkraut should be ready after 3 weeks. Store in refrigerator. This will slow down the fermentation process.

Once you have mastered sauerkraut, there is a whole world of fermented foods out there to try and enjoy. From kefir to fermented condiments (catsup, mustard, pickles) to kombucha and more.

Warning: Fermentation can be addicting!


- Brooke Lounsbury

Medical Content Writer

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Proverbs on Health

Many proverbs are based in some degree of truth. Let’s explore some of the more popular ones and examine the validity of their health claims.

An apple a day keeps the doctor away

Apples are a rich source of natural pectin and soluble fiber. Pectin is found in highest concentration in green, underripe apples and Granny Smith varieties. Pectin is used to thicken jams and jellies, but it has many health promoting benefits, such as:

  • Reduces inflammation in the colon. There is research pointing to the powerful anti-inflammatory properties of pectin in the colon. The water-soluble fiber found in apple pectin can help repair damage to the colon in people with inflammatory bowel disease.
  • Reduces cholesterol– Pectin reduces the absorption of dietary cholesterol in the gut which in turn reduces cholesterol. High cholesterol levels elevate the risk for stroke, heart disease and diabetes.
  • Normalizes blood sugars-Soluble fiber, such as apple pectin stabilizes and helps reduce high blood sugars.
  • Aids in blood pressure control
  • Regulate bowel movements- Soluble fiber, found in apple pectin along with psyllium, citrus and other vegetables promotes bowel regularity

The less you eat the longer you live

  • Calorie restriction has long been suspected of improving health and longer life span. Research is proving this theory correct. During calorie restriction the body frees up energy to regenerate and repair cells instead of having to expend energy on poor food choices, or overeating. A recent study conducted by a group of scientists from US and China have concluded that calorie restriction can provide protection against aging in cellular pathways. Calorie restriction also decreases inflammation and dramatically increases number of immune cells in almost every tissue.

Early to bed, early to rise keeps a man healthy, wealthy, and wise

  • According to a study titled “Early to bed, early to rise! Sleep habits and academic performance in college students” Compared to those with the lowest academic performance, students with the highest performance had significantly earlier bedtimes and wake times. About two thirds of the world’s billionaires wake at 4 am. Many cite less distractions because the rest of the world is still sleeping. Studies indicate early risers have a dramatically decreased instance of a major depression episode.

Seven days without exercise makes one weak

  • This proverb is self-explanatory and needs no explanation. Be sure to dust off your walking shoes and exercise, or at least go for long walks as weather permits. If the weather isn’t cooperating, find a you tube exercise video and set a goal of several times a week to stay or get in shape. There are many different types of videos, from easy yoga to exercises tailored to disabled to high intensity training. Something for everyone. An exercise buddy can be a powerful motivator to keep and stay on a schedule.

Never let the sun go down on your anger

  • Unresolved anger can result in an increase in cortisol levels. Cortisol is the body’s way of dealing with stress, diverting energy to parts of the body that may need to fight a perceived or imaginary enemy. Cortisol suppresses immune function and increases blood sugar. It is better to deal with anger before going to bed. Journaling, talking to someone, resolving conflict before bed will help lead to a healthier body and relationships.

Prevention is better than cure

  • Prevention is always better than taking time out for sickness. Evaluate and make changes that promote health. Plan and make healthy meals ahead of time for those days you don’t have time to cook. Put exercise in your appointment calendar. Take time for yourself. Maintain mental health by reaching out to friends and family. Make sure your car is ready for travel in extreme weather conditions, so you don’t get caught in the severe cold or heat dealing with a preventable car related breakdown. Reduce stress (keeps cortisol levels down) by setting up a budget and sticking to it. Plan your days, weeks and months. Be flexible. Take time out for self care and preventative maintenance. Keep your dental and doctors appointments. Don’t put off needed procedures and exams.

He was born with a silver spoon in his mouth

  • Throughout the centuries silver has been used for its antibacterial properties. Silver containers were used during Roman Greco times to keep liquids from spoiling. During the 1300s Bubonic Plague outbreak, parents would give their children silver spoons to suck on to prevent the plague.
  • Pioneers brought their knowledge of silvers antibacterial properties with them when they immigrated to America. They would drop silver coins in their water supplies to inhibit growth of bacteria and algae.
  • As recent as the 1950s, homemakers would drop a silver coin in milk to prevent spoiling.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Melatonin – It Isn’t Just for Sleep Part 2

In part 1 we reviewed the two types of melatonin and how they function in regard to circadian rhythm sleep/wake patterns and antioxidant properties.

In part 2 we will discuss:

  • Difference between seasonal affective disorder and winter blues, along with statistics
  • How melatonin and cortisol work to maintain sleep/wake cycles
  • Tips to overcome and deal with winter blues and help those affected by seasonal affective disorder

The difference between SAD and winter blues:

According to the NIMH:
SAD is not considered a separate disorder but is a type of depression characterized by its recurrent seasonal pattern, with symptoms lasting about 4 to 5 months per year. Therefore, the signs and symptoms of SAD include those associated with major depression, and some specific symptoms that differ for winter-pattern and summer-pattern SAD. Not every person with SAD will experience all of the symptoms listed below.

SAD statistics

  • 10 million people in the US are affected
  • 90 percent diagnosed in winter
  • 10 percent diagnosed in summer
  • Incidence increases as you go further north in latitude
  • Symptoms are present for about 40 percent of the year
  • Does not necessarily occur every year, about 50 percent skip years

Symptoms of major depression may include: (SAD)

  • Feeling depressed most of the day, nearly every day
  • Losing interest in activities you once enjoyed
  • Experiencing changes in appetite or weight
  • Having problems with sleep
  • Feeling sluggish or agitated
  • Having low energy
  • Feeling hopeless or worthless
  • Having difficulty concentrating
  • Having frequent thoughts of death or suicide


For winter-pattern SAD, additional specific symptoms may include:

  • Oversleeping (hypersomnia)
  • Overeating, particularly with a craving for carbohydrates
  • Weight gain
  • Social withdrawal (feeling like “hibernating”)

Specific symptoms for summer-pattern SAD may include:

  • Trouble sleeping (insomnia)
  • Poor appetite, leading to weight loss
  • Restlessness and agitation
  • Anxiety
  • Episodes of violent behavior

Winter blues statistics

  • Up to 14 percent of the general population experience some form of winter blues
  • As latitudes go up incidence also goes up-

Winter blues symptoms (not a clinical diagnosis)

  • Lack the motivation to complete some tasks but be able to handle major tasks
  • Still able to go to work and take care of home
  • Have trouble sleeping
  • Spend more time in bed than usual
  • Limited to winter months
  • Managed with lifestyle changes

Risk factors for both winter blues and SAD

  • Age-Younger people are more susceptible to winter blues than older population
  • Sex-Females are four times more likely be affected
  • Geography- Higher latitudes increase incidence
  • Family or personal history of depression

The role of melatonin cortisol in both SAD and winter blues

Melatonin- the sleep hormone

As stated in part 1, melatonin is produced in 2 places in the body- the pineal gland and mitochondria of cells. The pineal gland synthesizes melatonin during periods of darkness. This is tied to  the circadian rhythm, a roughly 24-hour biological wake/sleep cycle and accompanying physiological activities that occur during the cycle. Blue light, such as daylight and indoor bright LED lights, computer monitors, TVs phones and other devices that transmit blue light signal the pineal gland to shut down production of melatonin.

Cortisol- the awake hormone

Cortisol is a steroid hormone  synthesized by the adrenal glands, Adrenal glands are small triangular glands that sit on top of both kidneys. Cortisol has many functions in the body, from regulating  blood pressure, suppressing inflammation, a role in sugar metabolism and sleep/wake cycle.

Cortisol levels start to increase in the morning as melatonin levels decrease. This increase in cortisol and decrease in melatonin initiates awakening under normal circumstances.  Cortisol is also known as the “stress” hormone. It activates the fight or flight mechanism and triggers the release of glucose during times of stress, danger, or perceived danger.

Blue light, such as daylight and indoor bright LED lights, computer monitors, TVs phones and other devices that transmit blue light are one of the ways cortisol levels are triggered to increase. This is  results in more alert and wakefulness during daytime hours.

In conclusion:

Tips to combat winter blues and help SAD patients

Light boxes should be at least 10,000 lux at 15-18 inches for 20-30 minutes first thing in the morning. That will shut down melatonin and start cortisol production. Don’t stare directly into the box. Instead, read or do other activities as long as you are within the recommended distance from the light. Light boxes have really come down in price. As of this writing one highly rated 10,000 lux light box is under 20 dollars after coupon.

  • If able, get out for a one hour walk during the day. This will also help set your circadian rhythm.
  • Avoid computer, LED and phone screens after dark if possible. Limit your exposure by using a blue light blocking filter on the screens. This will help keep cortisol levels down and stabilize melatonin levels. Read by incandescent light if possible.
  • Avoid alcohol. Alcohol is a depressant. It also affects circadian rhythm if consumed late in the day.
  • Avoid sugar. Sugar consumption creates a sugar high followed by a sugar crash- leading to depression and moodiness
  • Eat a healthy, well-balanced diet. Make sure you are getting a good balance of fats, protein, and carbs.
  • Maintain a healthy vitamin D level. Consult your care provider for information. Vitamin D
  • Focus on or start a new hobby.
  • Keep warm. Staying warm and being properly dressed for the elements can lessen the burden on your body. Make a drink such as golden milk, made with turmeric, coconut milk, and a sprinkle of pepper for healthy, warm immune boosting drink. Recipe can be found here: Golden milk
  • Talk therapy- either reach out to friends, family or trusted neighbors and connect with others. If you are experiencing debilitating depression, suicidal ideation or unable to shake the slump, reach out to your primary care provider for evaluation. Don’t do this alone.
  • Remember, spring is only a few weeks away!

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

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Melatonin – It Isn’t Just for Sleep

Part one focuses on what melatonin is, part two will discuss how melatonin plays a role in winter blues or seasonal affective disorder, along with tips to navigate this time of year.

What is melatonin?

You may have heard that melatonin is a hormone that regulates sleep. You may have even heard that melatonin is a powerful antioxidant. Melatonin is both and a lot more.

There are two places melatonin is synthesized and both work in vastly different capacities.

One is subcellular melatonin and the other is circulating melatonin.

Subcellular melatonin is known as the “hormone of daylight” It is synthesized in the mitochondria of  cells throughout the body– skin, epithelial, liver, thyroid, kidney, gastrointestinal tract, bone marrow, leukocytes, immune cells and many others. Once manufactured the melatonin stays near the cells and does its work. Stimulated by the UV spectrum of sunlight, or viruses, free radicals are neutralized by the antioxidant response of melatonin. Melatonin also stimulates other antioxidant enzymes to help fight free radicals.

There is some evidence that subcellular melatonin is synthesized by exposure of near infrared light (NIR).

Circulating Melatonin

Circulating melatonin is known as the “hormone of darkness”. It is produced in the pineal gland and regulated by the suprachiasmatic nucleus (SCN) Melatonin secretion is stimulated by darkness and inhibited by light, and in coordination with the (SCN), it is involved in maintaining circadian rhythmicity and regulating sleep. The SCN regulates the timing of melatonin release in a feedback loop, whereby melatonin levels determine the SCN regulation.

 Circadian rhythm disruption is proven to be one of the contributing factors in cancer progression and development.  Blue light, such as LED and computer monitors suppress melatonin production, leading to altered circadian rhythm.

 Circadian rhythm disruption is proven to be one of the contributing factors in cancer progression and development.  Blue light, such as LED and computer monitors suppress melatonin production, leading to altered circadian rhythm.

How to benefit from subcellular and circulating melatonin

Before bedtime:

  1. Avoid stimulating lights- blue light from computer and phone screens, LED lights- these will shut down circulating melatonin and disrupt circadian rhythm. Incandescent light to read by are a good choice. Reading on a pad even with blue blocker can disrupt melatonin levels. The blue blockers installed on many devices are not adequate to block the light.
  2. Campfires, candles, and red lights help keep melatonin levels intact and may even stimulate the subcellular melatonin to go after free radicals.
  3. Practice sleep hygiene- Go to bed at set time, have a routine. This helps signal your body that its time to go to bed. In addition, avoid stimulating conversations, snacking before bed and exercise a few hours before bedtime.
  4. Have your vitamin D level checked. Vitamin D plays an important part of melatonin regulation.
  5. Even though there isn’t clear cut evidence that blue light blocking glasses work, a small study revealed sleep duration and nighttime melatonin levels increased after use of blue light blocking glasses.

Our lives have become increasingly distant from natural light. Our sleep wake cycles are constantly disrupted by our modern way of living.

Chronobiology, the study of circadian rhythms and our health is becoming an increasingly important field of study.  How light affects melatonin levels is one area that chronobiology focuses on.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

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